Critical Illness

CI: Hypocaloric Feeding Regimen (2011)

• Intervention
  Does the use of a low calorie, high protein feeding in critically ill obese adults impact mortality?

  • Conclusion

    The effect of hypocaloric high-protein feeding (less than 20kcal per kg ABW and two grams protein per kg IBW) on mortality in critically-ill obese adults is unclear.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: Does the use of a low calorie, high protein feeding in critically ill obese adults impact mortality?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Dickerson RN, Boschert KJ, Kudsk KA, Brown RO. Hypocaloric enteral tube feeding in critically ill obese patients. Nutrition. 2002; 18: 241-246.
  • Search Plan and Results: CI: Hypocaloric Feeding Regimen 2011
     
  Does the use of a low calorie, high protein feeding in critically ill obese adults impact infectious complications?

  • Conclusion

    The effect of hypocaloric, high-protein feeding (less than 20kcal per kg ABW and two grams protein per kg IBW) on infectious complications in critically-ill obese adults is unclear.  

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: Does the use of a low calorie, high protein feeding in critically ill obese adults impact infectious complications?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Dickerson RN, Boschert KJ, Kudsk KA, Brown RO. Hypocaloric enteral tube feeding in critically ill obese patients. Nutrition. 2002; 18: 241-246.
  • Search Plan and Results: CI: Hypocaloric Feeding Regimen 2011
     
  Does the use of a low calorie, high protein feeding in critically ill obese adults impact length of stay (LOS)?

  • Conclusion

    There is limited evidence that hypocaloric high-protein feeding (less than 20kcal per kg ABW and two grams protein per kg IBW) promoted shorter ICU stays in critically-ill obese adults, although total hospital LOS did not differ. Nitrogen balance was not adversely affected.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: Does the use of a low calorie, high protein feeding in critically ill obese adults impact length of stay (LOS)?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Dickerson RN, Boschert KJ, Kudsk KA, Brown RO. Hypocaloric enteral tube feeding in critically ill obese patients. Nutrition. 2002; 18: 241-246.
  • Search Plan and Results: CI: Hypocaloric Feeding Regimen 2011
     
  Does the use of a low calorie, high protein feeding in critically ill obese adults impact days on mechanical ventilation?

  • Conclusion

    The effect of hypocaloric high protein feeding (less than 20kcal per kg ABW and two grams protein per kg IBW) on duration of mechanical ventilation in critically ill obese adults is unclear.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: Does the use of a low calorie, high protein feeding in critically ill obese adults impact days on mechanical ventilation?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Dickerson RN, Boschert KJ, Kudsk KA, Brown RO. Hypocaloric enteral tube feeding in critically ill obese patients. Nutrition. 2002; 18: 241-246.
  • Search Plan and Results: CI: Hypocaloric Feeding Regimen 2011
     
  Does the use of a low calorie, high protein feeding in critically ill obese adults impact cost of care?

  • Conclusion

    There were no studies identified to evaluate impact on cost of care with use of a low-calorie, high-protein feeding in critically-ill obese adults.

  • Grade: V
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Search Plan and Results: CI: Hypocaloric Feeding Regimen 2011